720. I am still alive, I am very grateful for
that.
(Mr Milburn) One of these days I will convince you
of that. Unless you are going to have one supremo who is responsible
for every governmental function then, of course, there are going
to be different departments with different responsibilities, absolutely
right, but with one big objective. If you ask me to define what
the Government's big objective is overall, it is to ensure that
there is genuine opportunities for every section of society in
every part of our country, that is what we are about. The Health
Service happens to encapsulate that but so do our ambitions to
abolish child poverty or to create full employment or to ensure
that everybody has a decent home and a decent environment and
good public transport services and less crime on our streets.
Those are the Government's broad objectives. All of these have
a direct bearing on the health of the population and on people's
health opportunities.

721. I agree entirely that the health outcomes
will probably be the best measurement of how successful the Government
is at actually creating an enabling society. Can I ask a specific
question about the role of health authorities versus health trusts.
I do get a bit confused as to whether we still have a commissioner/provider
split when I look at the Health Bill that going through at the
moment, where delivery trusts are going to be directly influenceable
and rewarded by the secretary of state as with the influence of
health authorities. We also see that each trust by statute has
to have a Patients' Forum to influence its delivery. The minister
of state quite specifically said that this was a Patients' Forum
and not a Community Forum. That worries me slightly because trusts
are actually very good at influencing ex patients of their brilliance
and how wonderful they are. They tend to be fixed on the medical
delivery of acute services, whereas the health authorities are
allowed to have an ad hoc arrangement of public involvement.
If health authorities have to deliver the public health agenda,
which is not always the most popular in the short-term, how are
they going to be able to have enough influence over the trusts,
given that the trusts are going to have very powerful advocates
in the statutory Patients' Forum?
(Mr Milburn) I do not think the premise of your question
is quite right. I do not believe it is purely the responsibility
of the health authority to deliver improvements in public health.
Perhaps we will not get as far as we need to get. It is the responsibility
of the whole service, of community trusts, mental health trusts
and most importantly of all primary care trusts, all of these
organisations have a huge part to play. Within the primary care
sphere I believe thatI was talking earlier about the role
of GPs and other primary care professionals will playthe
advent of primary care groups and now primary care trusts, for
the first time, give primary care professionals the opportunity
to have a proper population-based focus, to focus on the needs
of its overall population, of 100,000 people or 70,000 people
or 150,000 people. That allows, in my view, at least the potential
for primary care professionals to get into another arena of activity
that is hugely important in determining the health care and the
Health Services on behalf of its local population. If GPs or as
other primary care professionals you find there are particular
problems amongst their patients, for example with poor housing,
lack of central heating or damp homes, whatever, for the first
time through the primary care trust group have you the opportunity
of doing something about it, not least in relation to the roles
that PCTs will play with local government. I think all of these
organisations within the health service, not just the health authorities,
have a responsibility to play on the Patients' Forum. I am completely
unapologetic about that. As recent events have rather demonstrated
all too graphically, the lack of direct patient influence, of
patients being on the outside rather than the inside of the National
Health Service have not always got their families, their relatives
the right sort of results from an NHS that is supposed to about,
primarily, serving the interests of patients.

722. I thought the NHS was there to serve the
interests of the community from which its patients came. It is
the concentration on the narrow user group rather than the broader
community that gives me some concern when we are talking about
the delivery of public health.
(Mr Milburn) On the Patients' Forum side they will
be comprised of two groups, although I do not think they are particularly
distinct. People who use the Health Service, and use it on a regular
basis, they have some insight into it. Actually, listening to
what patients have had to say and listening to their concerns
and complaints and, more importantly, imbedding the patient's
voice within the National Health Service at a local level will
make a real difference. That is one group. The second group are
patient organisations within the local community, the local MS
Society, the local Alzheimer's Disease Society. These local groups
are drawn from the local community but have a particular interest
and have a particular expertise which we ought to bring to bear
for the benefit of the local community and patients in general.

723. I have no doubt they will be formidable
advocates for the particular delivery of a medical treatment service.
Can I turn to the local delivery of public health. I was very
pleased to hear you say that you recognise that there are far
too many initiatives, and too many plans are having to be drawn
up. I hope that the Department will consolidate some of that.
Can I ask whether the plan is to base the joint working predominantly
on health geography or local authority geography? It is easy for
me, I am as coterminous as one could possibly be.
(Mr Milburn) You are at ease with yourself, are you?

724. I am totally at ease with myself. The health
improvement programme clearly may have a different area from the
community plan. I also find that the health improvement programme,
because it cuts across a number of local authorities, is not the
ideal unit to be looking at a local community. I think we should
be starting to talk about sub HImPS and a smaller population that
should create HImPs based on a district or unitary authority.
(Mr Milburn) Some of that is happening on an ad
hoc basis, the so-called HImP-lets. One of the amazing things
about the National Health Service is it does manage to engender
all sorts of interesting language which has a passing acquaintance
with the English language on occasions.

725. Almost as good as politicians.
(Mr Milburn) Some of that is beginning to happen,
and why not? Certainly within my own area, Darlington, it is a
very different place from the Teesdale and the East End of Durham,
the old mining communities, and they have very different health
problems. We have to have some ability and some flexibility to
plan for the needs of the specific local population. I do not
have a problem with that. As far as this issue of coterminousity
is concerned, I think this is quite a difficult issue for all
of us. The truth is there will never be a perfect set of boundaries.
You are the dealing with different organisations of different
traditions, different cultures, different representatives and
accountability structures. That is bound to be the case. All that
I say to people in the NHS, whenever they come to talk to me about
this, because the NHS likes nothing better than a really good
reorganisation, and it has had lots of them. It has lots of experience
in doing it. All that happens, or what tends to happen whenever
you have a reorganisation is that by and large people's eye is
taken off the ball and in the end what happens is that rather
than concentrating on getting the services delivered or the services
improved or the health of the local population improved people
start jumping into a position and wondering which job they are
going to get. Sometimes we need to reorganise and we need to change
things in terms of structures and institutions within the local
service. Sometimes it is better to take your foot off the accelerator
rather than always pressing it down.

Dr Stoate

726. Minister, one of big public health issues
I am interested in is men's health. Can I say I am pleased you
have been helpful and very useful in the Men's Health Forum, working
inside and outside this place, to tackle the big inequality facing
men at the moment. One of the issues I really want to talk about
is how as a GP we can try and improve health across different
groups. We were told recently that the Health Education Authority
carried out a survey and only 11 per cent of GPs understood what
the New Age targets were for exercise. What that really means
for me is that perhaps GPs are not as focused on the side the
public health agendas as they might be. How do you think we can
get GPs more on board with the Government's target for delivering
public health. I do not think at the moment they understand what
you are trying to achieve.
(Yvette Cooper) There are some GPs in some parts of
the country who are doing quite amazing work around public health
and who are leading the way in showing what can be done, whether
it is around coronary heart disease prevention or whether it is
around teenage pregnancy. It is interesting on the issue that
you mentioned, on exercise, the programme called Health Walks
that has been funded by the New Opportunities fund quite recently
as part of the Healthy Living Centres programme is all about improving
access to exercise and working through primary care to do that.
That has been driven by a GP. That has been driven by primary
care. There are some very good examples. The question is how you
spread those examples across the country. Primary care does now
have a duty and responsibilities for public health and health
improvement. What we need to do is to build on that over time.
It will take time. We should not have any illusions about the
fact there are no swift solutions. There is a huge amount going
on in primary care, with the shift of primary care trusts in many
areas. I think there is a huge amount that can be done. Perhaps
most will be done if we see primary care as a team and not simply
as the role of GPs, so the work that nurses in primary care do,
the work that health visitors do, the work, increasingly, that
community midwives may be doing if they are linked in, and so
on and so forth. There is a broad programme of work, it will take
us some time. The more that we have targets, for example, health
inequalities target, for example, the work on smoking cessation
and, for example, the implementation of the national service framework
for coronary heart disease, which requires a lot of work at local
level and through primary care, the more progress we will see
in this area.

727. That is fine. As you said, there are extremely
good examples of where GPs and primary care teams have been extremely
innovative with excellent results. My worry is there is a vast
bulk of GPs who are struggling day-to-day to see 50 patients a
day, sometimes more, plus on call. I find it quite difficult to
grasp the actual concept of public health and how it is that we
are trying to make any real difference. They feel swamped and
overwhelmed and they wonder what it that they can reasonably achieve.
(Yvette Cooper) Primary care groups and primary care
trusts will be the mechanism for doing that. They will have responsibilities
on public health and on health improvement. As a trust or as a
primary care group they will need to show progress and to make
progress and to be involved in the partnerships with other organisations
at the local level. That does not necessary mean that all GPs
within a primary care trust will instantly change the work they
are doing, or anything like that, it does mean that as a whole
the primary care trust is the mechanism. Obviously it is going
to involve more training and support for people in the new kinds
of functions. It may also be very much about the kind of teamwork,
or it may be that particular GPs specialise in particular areas
around public health. The honest truth of this is that I think
it is an area with huge potential. We have not worked out the
way in which it is going to work and a lot of it will be about
the way it develops at a local level. You can just see some of
the ways that some primary care trusts in some areas picked up
smoking cessation and are doing a lot of work there. There is
huge potential. What we need to do is follow what is working in
different areas and make sure that other areas can learn from
it.

728. Are you convinced that PCTs are the right
vehicle to deliver this programme?
(Yvette Cooper) They are such a massive resource.
GPs are seeing people on a day-to-day basis. People come into
their surgeries with health problems that are often linked to
all kind of different social problems or economic problems locally.
You have health visitors who are working with families with young
children at a critical stage of a child's development. What happens
in the first year of a child's life can have a huge impact not
simply on their health later on, but also on their education opportunities
and how they develop. Community nurses, people who are working
in the local community at a very tangible level. It could be something
as simple as identifying who it is that is suffering from fuel
poverty by just a simple question to them when they come to have
a flu jab, the primary care nurse asks. The potential for all
of these health professionals, who have huge contacts with the
community, and also with other organisations in the community,
the potential for them to deliver improvements in public health
I think is massive. It will take us a lot of time and we have
to be very realistic about the capacity of the NHS. It is a time
of great change and resources will only come on stream over time.
The potential is huge.

729. It is interesting what you said about very
young children and the contact they can have with health professionals.
It might interest you to know that in Cuba the GP visits every
child under one personally every day until they are one.
(Mr Milburn) Are you advocating that?

730. No, I think my colleagues would lynch me.
You said it was easy for a GP, a health professional, a health
visitor or a practice nurse to pick up poverty or housing problems.
That is fine and they do. What do they do about it? I still do
some medical work, if I see somebody in that position now what
I say is, "Go and see your MP", and they come and see
me again. That is the matter, Secretary of State, to pick up.
You can pick up these issues of poverty, GPs know about these
things, but what can a GP do about them?
(Mr Milburn) There are things that can be done for
the individual patient, a referral to the local authority, and
so on and so forth. That is not the trick we have to pull off.
What we have to pull off is a means of harnessing the expertise
of people in primary care with the knowledge that they gain from
their contact with people in the community in order to formulate
locally based approaches and strategies to deal with particular
problems that you and Dr Brand see in your surgeries. There will
be particular pockets of problems in particular areas, as there
are in my own constituency. Some parts of the constituency are
relatively affluent, some are pretty poor and they have specific
needs. I think based on that knowledge what we need to do through
the PCT structure, because it is operating at the level of the
general population rather than a specific group of patients on
a doctor's list, at that level what we to have to do is get the
PCT working together with the local authorities and the other
players in the community to formulate answers to the specific
problems that walk through the doors of GPs surgeries either to
see the family doctor or the local nurse. That is not easy to
doof course it is notbut the point about this is
that there is a bank of knowledge, both in terms of expertise
about solving problems and indeed about the nature of problems
themselves, that is located absolutely in the heart of primary
care. I do think this is an important issue in terms of how we
frame this whole debate around public health. I said earlier that
if we think that public health is just about certain professionals
within the National Health Service delivering certain services
we will not get anywhere. Public health is about how you mainstream
these issues right into the heart of the Health Service onto the
front-line of the Health Service and I think the PCT structure
offers the potential of doing that precisely because over time
you will seeand I am convinced of this and in the best
places it is already happeninggreater co-operation and
greater collaboration with local government services, not just
social services but environmental health services, transport services,
education services too.

Dr Brand

731. I think it is very ironic that we are having
this discussion whilst the local government settlement is being
announced because one of the reasons why I went into politics
was because one got very frustrated because one recognised there
was a problem but there were no delivery mechanisms. I think the
only way you are going to get primary team members to reach their
potential and start doing the work is to show that when they do
the work there is a result. When I refer people to me as an MP
I am almost as frustrated as a GP because fuel poverty and damp
housing is not something I can change there and then and that
is extraordinarily frustrating.
(Yvette Cooper) But it is something where there are
some local delivery mechanisms in some places being set up.

732. You need funding.
(Yvette Cooper) In some places they have set up partnerships
where the local authority has got a programme of improving insulation,
central heating and so on so they build a partnership with the
local health service on how are we going to prioritise, who is
going to get the heating first, who is going to get the help.
There is all kinds of work going on home energy efficiency schemes
and support to tackle damp housing. Those problems exist. The
problem is matching them with the people who need them most and
the Health Service is actually a brilliant way to match people
but only if the co-ordination mechanisms are in place, and they
are in some places and they could be in many more.

Chairman: Can I say we will adjourn for ten
minutes.

The Committee was adjourned from 18.02 to
18.12 for a division in the House.

Chairman

733. Colleagues, could we recommence. I hope
we can conclude in just over 15 minutes. Before we move away from
the point Howard raised, he mentioned men's health and certainly
one of the issues that has come out as a concern in this inquiry
is the extent to which we have a lot of work to do in that area.
As a Committee we feel quite strongly we need to look at that
very closely. One of the issues that struck me in some of the
visits we did was the fact that the front-line workers who were
addressing this were primarily female and I wondered whether if
any of the initiatives looked at the way in which you may involve
more men in advising men on male health and looked at possible
alternative models. I am involved in something you may be aware
of on testicular cancer. I will not go into the rather laddish
messages we put across but it is an important health message targeted
at male spectators of sport. Have you any examples of how you
are addressing this as an issue and the staff involved in front-line
advice giving?
(Mr Milburn) The best one that springs to mind is
again in Bradford. Certainly on my visit there I had an opportunity
to meet some of the male primary care staff, community staff,
who were providing health promotion services but in a rather different
way than perhaps they had been provided in the past. They were
doing lots of "surgeries" in pubs and clubs and getting
an incredibly good response, it has to be said. There is quite
a bit of that in various places and some of the health action
zones (not all but some of them) have helped to pioneer some of
that work. I think there are some quite important lessons that
are to be learned. It is true that basically men are not as forthcoming
as women are about some of these health problems and actually
it is important that we therefore have the debate with men on
terms that they relate to and understand and in some of the venues
that they feel comfortable in. That struck me as a very good example
but I am sure there are very many others. The issue is, as always
in the NHS, how you generalise from the particular and make sure
those examples of good practice become more generalised across
the piece. I am optimistic about this because I think that both
for women and more men there is such an obvious and growing interest
in their own health. You can see that whether it is in types of
magazines that have been sold, the growth of gyms and fitness
studios or whether it is the number of sports shops on the high
street. People are more and more interested, quite rightly, in
health issues that affect them, not necessarily Health Service
issues either, about their own health. The issue is how best the
National Health Service, which has tended to give a fairly passive
response to demand, can relate to quite a different order of interest
in the population about people's own health.
(Yvette Cooper) I was going to say that it is not
even just about the services, it is also the health information
that we provide. I think the traditional approach of the health
information campaigns has been to target women. It has been the
traditional approach. You think about women as the guardians of
family health so health messages go to women rather than to men.
That perpetuates a situation in which men feel less empowered
when it comes to talking about health, that health is not something
to do with them. It is something we have made a conscious effort
to address with new campaigns. So, for example, the teenage pregnancy
campaign is very explicitly as much about boys as it is about
girls, and is very conscious of the different approaches that
boys and girls might take or different things that might resonate
and it is very clearly about teenage boys as much as it is about
teenage girls. Equally, the flu jab campaign we did involved Henry
Cooper. We have been very conscious of trying to make sure that
the campaigns that we run are as much about men as about women.
Another interesting point I would make is that health inequalities
issues between low and high income become very clear here as well
because what you see over time is high income men catching up
with women when it comes to life expectancy but low income men
falling further and further behind. You also have to look at inequalities
in terms of income as well as the differences between men and
women.

Dr Stoate

734. If I could ask a couple of specific questions,
Secretary of State. A bit of a googly for you really: why has
it taken so long to publish Sir Kenneth Calman's Report on public
health function, which has been promised for some time now? Is
there a particular reason it has not been published? Do you intend
to publish it quickly and, if not, why not?
(Mr Milburn) I hope we can publish it quickly. I hoped
we might have been able to publish it this week but for various
obvious events we have not. It is literally on the stocks and
it has been with Ministers and it will be published, I hope, within
the next few weeks. The major reason is that we had a change of
Chief Medical Officer and it was important that Liam Donaldson
had an opportunity to put input into it.

735. My next question is about the fluoridation
of water. When we took evidence from the Sandwell Authority, which
is a most deprived area, when they fluoridated the water 13 years
ago they found dramatic improvements in the health of kids under
14 in their oral health, particularly in fillings. What is your
Department doing about the fluoridation of water? Why is it not
being rolled out across the country, do you have any plans to
do so?
(Mr Milburn) As you know we commissioned a study from
the University of York which was published in October last year.
It was an important study, yet in some ways it was disappointing
in that it did not in the end make clear any firm recommendations
for action. What it concluded, as you remember, is that overall
the fluoridation of water had a positive oral health impact. If
the people from Sandwell have told you that then their evidence
bears that out to you. As far as they could see from the evidence
there were not adverse health risks associated with the fluoridation
of water but nonetheless they went on to say that there was not
as much primary research around, and the primary research that
was around was pretty dated. They recommend that we needed more
research and, indeed, that is what we are doing. We are talking
to the Medical Research Council about how we can go about getting
more primary research. The problem of doing that is that it takes
time. If you are going to have a whole series of population studies
it is going to take some time to get. There are very different
views about this, as you know. My post bag is full of very different
views on this issue. I suspect that members around this table
have different views. My own view is there are probably big benefits
in fluoridation. As with all things, we have to make the policy
decisions on the basis of the best evidence. Indeed, I think it
is true of public health policy generally that we think we know
what works very often but sometimes there is just not an evidence
base for it. If we are going to invest public money and we are
going to develop new strategies and new interventions then, above
all else, we have to be pretty sure they are going to work.

736. I am disappointed more is not being done.
The Americans have done it now for the last 20 years. They have
a wealth of evidence and, as far as I am aware, very little adverse
evidence. If a country like America can accept it wholeheartedly,
virtually all American states are fluoridating their water
(Mr Milburn) I am happy to send you a copy of the
report. We commissioned the report precisely because there are
so many different views about this and to try to get a clear evidence
base for any policy decision we took. As I say, the conclusions
of the report were clear in one regard but were not in another
and, therefore, we have to act appropriately. However, that does
not mean that in the meantime there will not be discussions, particularly
in those parts of the country where we know there is poor oral
health, deprived areas in particular, with the water companies
about pressing forward the fluoridation schemes.

Siobhain McDonagh

737. We have already heard earlier on about
how you feel that the target for reducing child poverty is probably
the biggest single commitment the Government has made and is going
to have an impact on public health. Can you tell me what other
Government measures have had an impact on public health?
(Mr Milburn) The measures that will have an impact,
a lot of these things are for the long-term rather than the short,
are around the whole effort we are making to improve people's
standard of living and to provide more opportunities for them.
I think the things we are doing to lift people out of poverty
are particularly significant here, whether that is child benefit,
the minimum wage, the Working Families' Tax Credit, the New Deal,
and the measures we are taking to enhance the employment opportunity
and to make sure that if people are in employment they have a
decent living wage. These are important measures. I think the
New Deal for Communities, the single regeneration budget investment,
and so on, are also significant because along with Sure Start
what they do is target resources in those parts of the country
which need most regenerative effort and require, frankly, additional
resources in order that we give people precisely the opportunities
that have been available to some communities but not to every
community. I think these measures are very, very important, reflecting
Dr Brand's earlier point, they are very, very important measures
in their own right, but they are also very important public health
measures too. Over time they will pay dividends. There is little
doubt about that. If Black is right, if Acheson is right, if Donaldson
is right, if a wealth of science expertise and medical opinion
is right then lifting people up and creating, in the crudest of
terms, a fairer society is bound to have an impact on people's
health opportunities too. I think a fairer society and a healthy
society are two sides of the same coin.

738. How can performance in tackling health
inequality be better managed? How can you enforce targets and
monitor progress, given that the rest of the health service is
run like that?
(Mr Milburn) It is very, very important the development
we announced in the NHS plan. There was a lot of to-ing and fro-ing
about this. There were very mixed views about this. In Our Healthier
Nation we said that we would press ahead with a policy of local
health inequality reduction targets and some of that has been
happening through the health improvement programmes, and so on
and so forth. There was a debate inside the Department and in
the Modernisation Action Teams about whether we should press ahead
with national inequality targets. My own view, and Yvette Cooper's
too, was that that was the right thing to do. In the end you have
to believe that what we have been talking about in terms of child
poverty reduction and the interventions that we can better make
in health are going to produce the right results. One thing that
is crystal clear about the NHS as a managed service is that if
you set a target that influences behaviour. It influences behaviour
amongst clinicians and amongst managers. The fact that we are
going to have, for the first time, a health inequality target,
I hope we well be announcing before too long, I think will gear
the Service to better recognising that this is a very important
arena of activity for us in a way that has, perhaps, been neglected
in the past. We have brought in new expertise to help us do that.
We have brought in Don Nutbeam, who is a professor of public health
of the University of Sydney, to lead our public health effort
and specifically to help us with the devising of an effective
but also a challenging health and equality target.

739. I am only a very new member of the Health
Select Committee and I have really enjoyed my time on it, particularly
hearing about the local schemes and the really imaginative ideas
that people have about regenerating their areas and improving
health. All our discussions show they go hand in hand. One of
the things that has come up as a minor issue is that the NHS can
often be the biggest employer, the most well resourced organisation
in any constituency or any borough. Do you think the NHS understands
its role as employer, as an owner of property, as an owner of
land, as a planner, in relation to what it could do to be involved
in these particular regeneration schemes. Do you think the Department
and NHS Executive actually understand it?
(Mr Milburn) I think the frank answer to that is probably,
no, we do not or the NHS does not. There is real work to do there.
It is absolutely the case, in my constituency, and I guess in
most others, if it is the true that the NHS employs one in five
of the public sector work force and one in 20 of the whole country's
work force, and it is going to be a growing work force, that must
be reflected in most constituencies in the land. The NHS has some
broad responsibilities, as Dr Brand was indicating earlier, not
just to the patients that it serves but also to the wider community
that it serves. It is a very important local employer generally.
We try to encourage it to get involved at a local level with the
New Deal to provide employment opportunities for the long-term
unemployed and for the youth unemployed. Although there has been
some success there I think a lot more can be done. As far as regeneration
efforts are concerned I think probably the most significant thing
we have done to date, and I think we need to do more, is the announcement
we made in the NHS plan that we would have joint public health
groups jointly reporting to the regional offices of the NHS through
the NHS Executive and to the regional offices of government. That
will, I think, allow something to happen that has happened sufficiently
to date, which is that in all of these big regeneration schemes,
whether they are New Deal for Communities or the Single Regeneration
Budget or whatever for the health benefits and the health impact
of those schemes to be better recognised from the outset. What
I want to see is a lot more NHS input into regenerated activity
both at a regional level, but at a local level as well.

John Austin

740. Could I just follow on on that because
you talk about input there but you are talking about input on
the basis of ensuring there are good health outcomes from regeneration
schemes. I think clearly in the ones I have looked at there have
been measurable or potentially measurable health benefits, but
there have been very few regeneration schemes which have been
health-led rather than health being a positive good coming out
of the economic and education schemes, or whatever it is. Do you
think there is much more scope for looking at health becoming
a driver and health being a regenerative engine itself?
(Mr Milburn) Yes, I think there is scope for some
of that and, indeed, I am considering at the moment the next wave
of major capital developments within the NHS following from the
first and second wave of PFI and other schemes, including the
one in your own area. Of course, you always have an eye on the
potential broader impact that a major scheme of this sort can
have in the local community. If you are going to spend £100
million, let alone £200 million or £300 million, and
we have got some very, very big initiatives now coming through
in terms of hospital developments in particular, they can not
only provide the local community with a better local health service
but potentially they can also have a very big knock-on effect
into regenerative and economic development activity in a local
community too. We try to do that at a national level, but I think
the point that was being made earlier was that that needs to be
replicated right down the command chain to both regional and local
level, and I am convinced there is a lot more that can be done
in that regard.

Chairman

741. Are there any urgent final points Members
want to raise or any points either of the ministerial team want
to make? If not, can I thank you both for coming along today.
We are most grateful to you and I hope our report will be of some
help.
(Mr Milburn) I am sure it will.